Musculoskeletal MRI protocol

The authors propose a musculoskeletal (MSK) magnetic resonance imaging (MRI) protocol using selected sequences for common orthopaedic indications. Selected sequences allow optimal visualisation of the indicated pathology while screening for other common conditions. The authors emphasise the need for standard positioning of the patient and standard orientation of scan planes to facilitate comparison with follow-up scans.

Migration of the tip of a central venous catheter

Presented here is a 47-year-old man for whom right central venous chemoport catheterization was performed without radiological guidance. Within 8 days, the catheter became nonfunctional and non-contrasted thoracic CT was performed to trace its course. The tip of the catheter appeared to have perforated the opposite wall of the ipsilateral brachiocephalic vein and entered the adjacent brachiocephalic artery. It then maintained its course along the ascending aorta to perforate, once again, the opposite wall of the aorta before finally resting in the aortopulmonary soft tissue. Migration of chemoport is not uncommon, and may present in many ways. However, it is rare for a migration to occur in the way described here and only present with catheter blockage. Radiological guidance of any central vascular catheterization greatly reduces the risk of complications